The World Health Organization (WHO) has published its first-ever reports highlighting the critical shortage of medicines and diagnostic tools for invasive fungal diseases. The reports underscore the urgent need for increased research and development (R&D) to address these gaps and prevent life-threatening infections.

Fungal diseases have become a growing global health threat, with some common infections—such as Candida, which causes oral and vaginal thrush—becoming increasingly resistant to treatment. These infections disproportionately affect severely ill patients and those with weakened immune systems, including individuals undergoing cancer treatment, living with HIV, or recovering from organ transplants.

“Invasive fungal infections threaten the lives of the most vulnerable, but countries lack the treatments needed to save lives,” said Dr. Yukiko Nakatani, WHO’s Assistant Director-General for Antimicrobial Resistance ad interim. She emphasized that not only is there a shortage of antifungal medicines, but many low- and middle-income countries (LMICs) also lack basic diagnostic tools, making it difficult to identify infections and administer appropriate treatments.

A Dire Shortage of Life-Saving Antifungal Drugs

The WHO’s fungal priority pathogens list (FPPL) classifies the deadliest fungi, some of which have mortality rates as high as 88%. Despite this, progress in antifungal drug development has been slow. In the past decade, only four new antifungal drugs have received regulatory approval in the U.S., European Union, or China. Currently, nine antifungal drugs are in clinical trials, but only three have reached the final stage of development—meaning few new treatments are expected in the next decade.

Existing antifungal drugs come with significant challenges, including severe side effects, drug interactions, limited dosage forms, and the need for prolonged hospitalization. Paediatric patients are particularly underserved, with few clinical trials exploring child-friendly formulations. WHO calls for increased investment in drug development to create safer and more effective antifungal treatments that can be widely accessible.

The Diagnostic Gap: A Major Barrier to Treatment

Alongside the drug shortage, the lack of reliable and accessible diagnostic tools is a critical issue. While tests for fungal infections do exist, they rely on well-equipped laboratories and trained professionals—resources that are often unavailable in LMICs. The WHO report highlights the need for faster, more affordable, and easier-to-use diagnostic tools, especially those that can be used at or near the point of care.

Current diagnostic tests have limitations, such as slow turnaround times, restricted accuracy, and the inability to detect a wide range of fungal pathogens. Many health workers are also not adequately trained to recognize fungal infections or understand the increasing resistance of fungi to treatments. Without proper diagnostics, patients remain undiagnosed, leading to unnecessary deaths.

A Call for Global Action

To combat this growing threat, WHO is urging global investment in fungal disease research, increased financial incentives for drug development, and improved diagnostic infrastructure. The organization is also developing an implementation blueprint for the FPPL to strengthen the global response against invasive fungal diseases and antifungal resistance.

With fungal infections on the rise and treatment options limited, WHO’s call to action serves as a stark reminder that urgent efforts are needed to prevent a looming public health crisis.